NPIMap

Individual provider Active NPI

Michelle E Mullins, NP

  • Nurse Practitioner
  • Gulfport, MS
National Provider Identifier
1548893605
Registry record updated Feb 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
903795 Issued in MS
Practice address
4215 15TH St
Gulfport, MS 39501-2523
Phone
(228) 863-5211
Fax
(228) 863-4101
NPI assigned
Feb 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 903795 MS Primary

Addresses

Primary practice location

4215 15TH St
Gulfport, MS 39501-2523

Mailing address

4215 15TH St
Gulfport, MS 39501-2523
Phone (228) 863-5211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200414000001 MS Practitioner - Nurse Practitioner 7719317841 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians

Practice addresses (Care Compare)

4215 15TH St
Gulfport, MS 39501-2523
Phone (228) 863-5211

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital at Gulfport Current Accepting new patients
Memorial Hospital at Gulfport CurrentSince Mar 16, 2020 Accepting new patients
Memorial Hospital at Gulfport Past Accepting new patients

Locations

1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856

1203 Broad Ave
Gulfport, MS 39501
Phone (228) 547-8814

4215 15th St
Gulfport, MS 39501
Phone (228) 863-5211

4500 13th St
Gulfport, MS 39501
Phone (228) 236-3872

Interoperability endpoints

  • Direct secure messaging: mmullins@direct.mhg.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 60

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 60

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1581984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581984000000",
    "number": "1548893605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4215 15TH ST",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012523",
            "telephone_number": "228-863-5211",
            "fax_number": "228-863-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4215 15TH ST",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012523",
            "telephone_number": "228-863-5211",
            "fax_number": "228-863-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLINS",
        "first_name": "MICHELLE",
        "middle_name": "E",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-18",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "903795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.